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Federal judge rules against Blue Cross in autism lawsuit

Steve Carmody/Michigan Radio

A federal judge has ruled that Blue Cross must pay hundreds of Michigan families who were denied coverage for behavioral therapy for children with autism.

Blue Cross contends the therapy is experimental, but doctors disagree.

The ruling may cost Blue Cross about five million dollars.

Attorney Gerald Mantese represented the hundreds of Michigan families that sued Blue Cross. He says the judge found Blue Cross/Blue Shield of Michigan’s  “characterization of Applied Behavioral Analysis Therapy as ‘experimental’ was totally arbitrary…and contrary to the medical evidence.”

Mantese is also an attorney in a similar lawsuit in Philadelphia against Cigna insurance. Thousands of autism patients are involved in that lawsuit.

“This ruling will help us fight against (Cigna),” says Mantese.

Blue Cross/Blue Shield of Michigan may appeal the federal judge’s ruling.

Steve Carmody has been a reporter for Michigan Public since 2005. Steve previously worked at public radio and television stations in Florida, Oklahoma and Kentucky, and also has extensive experience in commercial broadcasting.
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